Bibliotherapy for health and wellbeing: an effective investment.

• Author: Turner, June
• Position: Report

Bibliotherapy activity in Essex is described and the development of bibliotherapy in the UK reviewed, drawing on an audit prepared for Arts Council England and the Museums, Libraries, and Archives Council in 2006. There is a focus on book prescription but also covered is the use of creative literature to promote health and wellbeing, and the filtering of information on prescription by some UK library services. Edited version of a paper presented at the Reading Critical conference, State Library of Victoria 11-12 April 2008.

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The term bibliotherapy (1) was coined during the first world war but it was not until the 1930s that the concept of using books to support mental wellbeing really came into its own.

In a recent feature article (2) in the UK's Guardian newspaper Blake Morrison showed how the idea that literature can make us emotionally and physically stronger goes back to Plato. He went on to investigate the rise of bibliotherapy in relation to reading groups, focusing on a Get into Reading (3) scheme in Merseyside which works with people in mental or physical distress. This type of bibliotherapy uses creative literature to promote health and wellbeing. The benefits of sharing reading with others and the contribution to wellbeing is much documented and regularly observed within reader development practice in libraries. (4) The difference, though, with the Get into Reading scheme and the other well developed creative bibliotherapy scheme in England, Reading and You Scheme (Rays) (5) is that these projects set out directly to have an impact on wellbeing. Rays has bibliotherapists who use reading and the sharing of reading with others to help people experiencing mild to moderate depression, stress, anxiety or social isolation--relax and talk about their feelings with benefits for their health and general wellbeing.

The most common form of bibliotherapy in the UK, however, is the use of self help books. There is established practice within the mental health profession of using self help books with clients. In 2003 a Cardiff doctor Dr Neff Frude developed a partnership model working with Cardiff Libraries whereby a GP or mental health professional could prescribe a book and the client could get the book from their local library. 1600 prescriptions were exchanged for a book in Cardiff libraries during the first year. This book prescription model has spread rapidly and an audit of bibliotherapy practice (6) in 2006 found that more than half of English local government authorities were involved in bibliotherapy, the majority with book prescription schemes and most commenced very recently. That is exactly the case in my own library service, Essex, where a book prescription scheme was launched in 2006 in partnership with a primary care trust. In common with most other schemes, the National Health Service partner initiated the development. The drivers for this in the health sector are policy directives such as the promotion of healthy living and self care, the emergence of the expert patient concept and the need for effective use of resources.

I will now describe bibliotherapy activity in Essex and then look at the challenges and benefits highlighted in the national bibliotherapy audit, with particular reference to the Essex experience. I am only referring to activity which has been working directly with the health sector.

* book prescription

* cancer information

* creative bibliotherapy with the mental health sector.

Book prescription

The key components of a book prescription scheme are

* mental health professionals select a number of titles

* the library service stocks the agreed titles

* doctors and mental health professionals then issue a book prescription for a specific book, with the patient going to the library with the prescription rather than to the chemist.

The book prescription scheme is aimed at people who are well motivated and able to benefit from the self help route of reading a book. Generally they will be in work and suffering from mild depression, anxiety or similar disorders.

We launched a book prescription scheme in July 2006 in partnership with the primary care trust in the north of the county. A primary care trust (PCT) is the organisation with responsibility for local health care in any given geographical area. At the time I was first approached about a book prescription scheme there were 13 different PCTs covering Essex. I was very keen to see a book prescription scheme in Essex but wanted to aim for implementation right across the county, with all of the primary care trusts. We did manage to get a steering group with representatives from each of the geographical networks - and were almost on the point of achieving consensus about a range of issues from the publicity to the details of the titles--when a major...